Pterygium Surgery: Conjunctival Autograft Using a Fibrin Adhesive

Marticorena, Joaquín; Rodríguez‐Ares, María Teresa; Touriño, Rosario; Mera, Purificacion; Valladares, María; Martinez-de-la-Casa, José M.; Benítez-del-Castillo, J.M.

doi:10.1097/01.ico.0000164780.25914.0a

Cited by 79 publications

(47 citation statements)

References 13 publications

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“…Outros estudos utilizando os diversos tipos de cola de fibrina existentes também demonstraram essa importante vantagem, com tempo cirúrgico significantemente menor em comparação com a fixação mediante sutura (4,12,(17)(18) . Sabemos que a avaliação do desconforto ocular por meio do questionário de escala análoga não é isenta de viés, principalmente pela subjetividade dos sintomas, com diferenças pessoais no julgamento de diferentes estímulos; entretanto, em nosso estudo, todos os pacientes receberam as mesmas orientações pré e pós-operató-rias, dadas pelo mesmo médico, sem distinção entre os diferentes tipos de tratamento.…”

Section: Discussionunclassified

Eficácia do adesivo tecidual de fibrina na fixação de enxerto conjuntival autógeno em cirurgias de pterígio primário

Rubin¹,

Dantas²,

Nishiwaki-Dantas³

et al. 2011

Arq. Bras. Oftalmol.

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RESUMOObjetivo: Comparar a eficácia da fixação do enxerto autógeno de conjuntiva ao leito escleral após exérese de pterígio primário, utilizando-se adesivo tecidual de fibrina ou sutura de monofilamento de nylon 10-0. Métodos: Estudo comparativo, prospectivo e aleatório foi realizado em 47 olhos de 47 pacientes com pterígio primário de localização medial. O grupo 1 (adesivo) foi constituído de 21 pacientes submetidos à fixação do enxerto conjuntival com adesivo tecidual de fibrina (Quixil TM ); enquanto que o grupo 2 (sutura), foi constituído de 26 pacientes, cuja fixação do enxerto foi feita com sutura em pontos separados de monofilamento de nylon 10-0 (Ethicon ® ) após a excisão do pterígio feita pelo mesmo cirurgião. Os pacientes foram avaliados antes da cirurgia, no 1º, 14º e 21º dia após a cirurgia. Utilizou-se uma escala visual de desconforto ocular e verificou-se o tempo cirúrgico, hiperemia ocular e presença de complicações, além de sinais de recidiva, sendo sua presença também avaliada no 6º mês após a cirurgia. As variáveis foram submetidas à análise estatística. Valores de p<0,05 indicaram significância estatística. Resultados: O tempo cirúrgico médio foi de 19,05 ± 6,12 minutos para o grupo 1 e 48,15 ± 7,13 minutos para o grupo sutura (p<0,001). A escala referente ao desconforto ocular demonstrou um menor escore no 1º (p<0,005), 7º (p<0,001) e 21º (p<0,001) dia após a cirurgia com a utilização do adesivo tecidual. A hiperemia ocular mostrou-se menor em todos os períodos do estudo após a cirurgia (p<0,001) no grupo cola. As complicações encontradas, uma em cada grupo, resolveram-se com tratamento clínico até o 21º dia após a cirurgia. Houve uma recidiva no grupo 1 e duas no grupo 2 até o 6 º mês após a cirurgia. Conclusão: Em cirurgia de fixação de enxerto autógeno de conjuntiva para tratamento de pterígio primário, adesivo tecidual de fibrina reduziu o tempo do ato cirúrgico, desencadeou menor hiperemia conjuntival e desconforto no período pós-operatório, com índice de recidiva semelhante em comparação com o uso de sutura de mononylon 10.0, demonstrando ser uma excelente opção para a fixação do enxerto conjuntival no tratamento cirúrgico do pterígio primário. Descritores

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Section: Discussionunclassified

Eficácia do adesivo tecidual de fibrina na fixação de enxerto conjuntival autógeno em cirurgias de pterígio primário

Rubin¹,

Dantas²,

Nishiwaki-Dantas³

et al. 2011

Arq. Bras. Oftalmol.

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“…These findings were also consistent with the studies of CA using fibrin glue, in which a number of different symptom scales have been used. [4][5][6][7][8] Shortening the surgery time and improving post-operative comfort may have several advantages. First, the use of fibrin glue removes the need for the tedious suturing process, the learning curve can be shortened, and better results may be more consistently achieved despite differences in surgical expertise.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6][7][8] In addition, the outcomes of AMT using fibrin glue for corneal ulceration, perforation, and ocular surface reconstruction have been reported in clinical and experimental studies. [9][10][11][12][13] However, the results of pterygium surgery with AMT using fibrin tissue sealants have been evaluated in limited number of studies.…”

Section: Introductionmentioning

confidence: 99%

Amniotic membrane transplantation using fibrin glue in pterygium surgery: a comparative randomised clinical trial

Küçükerdönmez

Karalezlı

Akova

et al. 2009

Eye

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Purpose To compare the results of amniotic membrane transplantation (AMT) using fibrin glue vs vicryl sutures in pterygium surgery. Methods We carried out a prospective, randomised clinical study of 70 eyes (70 patients) with primary pterygium. After the removal of pterygium, patients were randomised to undergo AMT using fibrin glue (Tisseel, 32 eyes) or 8-0 vicryl sutures (38 eyes). Clinical examination and digital photographing were performed at each visit and the patients were followed up for at least 12 months. Post-operative symptoms in the first month were evaluated according to a fivepoint scale. Final appearances were graded from 1 to 4 in which grade 4 represented true (corneal) recurrence and grade 3 indicated conjunctival recurrence. Results The average operation time in the fibrin glue and suture groups were 11.2 ± 2.4 min (mean ± SD) and 18.7 ± 2.2 min, respectively (P ¼ 0.018). Significantly fewer post-operative symptoms were observed in the fibrin glue group at post-operative days 1, 7, and 14 (Po0.05 for all). At the end of the follow-up, true recurrence (grade 4) was developed in three eyes (9.4%) in the fibrin glue group, and in four eyes (10.5%) in the suture group (P ¼ 0.33). The rates of conjunctival recurrence (grade 3) were 21.9% (seven eyes) and 23.7% (nine eyes) in the fibrin glue and suture groups, respectively (P ¼ 0.38). Conclusions Amniotic membrane grafts can be successfully attached without any major complication in patients undergoing pterygium surgery. In addition, it is effective in shortening the duration of surgery and preventing post-operative discomfort. Although there seems to be no difference in the recurrence rates and cosmetic outcomes between both groups, neither technique represents best results.

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“…In Dr. Ashok K Sharma's study, out of 150 cases who underwent graft fixation with autologous blood during followup recurrence was seen in 4 patients -2.6%, 2 patients had graft retraction and 1 patient had Tenon's granuloma. [18] Other studies show a recurrence of 3% -6% (Kenyan) in 1985, 6% with Vastin, Dr. Amitav Das et al and AIOC proceedings in 1999 shows no recurrence where conjunctival graft was done in 42 patients of Pterygium.…”

Section: Discussionmentioning

confidence: 99%

Conjunctival Autograft With Autologous Blood Coagulum in Primary and Recurrent Pterygium- An Observational Study

Mohandoss¹,

Rao²,

Santhosh³

2017

jemds

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BACKGROUNDPterygium is a triangular wing-shaped encroachment of bulbar conjunctival tissue extending to cornea. It is a degenerative and hyperplastic process, in which conjunctiva actively invades the cornea. The aim of this study is to investigate the efficacy of limbal conjunctival autograft in primary and recurrent Pterygium and to report the incidence of recurrence after surgery using conjunctival autograft with autologous blood coagulum. MATERIALS AND METHODSA hospital-based observational study of one-year duration was conducted in 45 patients with pterygia for whom conjunctival autografting was done. Both males and females of age group 20 -60 years were included in the study. Pterygium excision was done and autograft placed on the blood coagulum over bare sclera and patients were followed postoperatively on Day 1, 7, 30 and then every 2 months until six months and was assessed for visual outcome and symptomatic improvement. RESULTSIn this study 16% cases were in age group 20 to 30 years, 33% in 31 to 40 years, 24% in 41 to 50 years and 27% in 51 to 60 years. High incidence was seen in patients working outdoor than indoors (64% versus 36%). Higher incidence was noted in females (64%). Fewer complications noted like granuloma formation in 1 patient and 4 patients developed recurrence. CONCLUSIONAutologous conjunctival grafting is a safe, economical and effective procedure with narrow learning curve. It prevents recurrence of pterygium and reduces the surgical time with fewer postoperative complications. KEYWORDSPterygium Surgery, Autologous Blood, Autograft, Fibrin Glue. HOW TO CITE THIS ARTICLE:Mohandoss SD, Rao KS, Santhosh MT. Conjunctival autograft with autologous blood coagulum in primary and recurrent pterygium-an observational study.

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Pterygium Surgery: Conjunctival Autograft Using a Fibrin Adhesive

Cited by 79 publications

References 13 publications

Eficácia do adesivo tecidual de fibrina na fixação de enxerto conjuntival autógeno em cirurgias de pterígio primário

Eficácia do adesivo tecidual de fibrina na fixação de enxerto conjuntival autógeno em cirurgias de pterígio primário

Amniotic membrane transplantation using fibrin glue in pterygium surgery: a comparative randomised clinical trial

Conjunctival Autograft With Autologous Blood Coagulum in Primary and Recurrent Pterygium- An Observational Study

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